Kidd Vasco Deon, Douglas Geraldina
Orthopedic Surgery, University of California Irvine School of Medicine, Irvine, USA.
Perioperative Services, University of California Irvine School of Medicine, Irvine, USA.
Cureus. 2024 Aug 26;16(8):e67820. doi: 10.7759/cureus.67820. eCollection 2024 Aug.
Introduction There have been exponential growth and increased interest in postgraduate residency/fellowship formalized training among nurse practitioners (NPs) and physician assistants/associates (PAs). Although not a requirement for state licensure and entry-level practice, postgraduate NP and PA residency/fellowship programs offer a structured pathway for new graduates and experienced PAs and NPs looking to transition into a new medical or surgical specialty/subspecialty. In this article, we examine the perceptions of employed NPs and PAs toward postgraduate training including the concept of developing a program at our institution. Methodology This was a cross-sectional single-large academic medical center (AMC) study, where an anonymous electronic survey was initially developed by the director of advanced practice providers (APPs). The survey was piloted by members of the Advanced Practice Council (APC) comprising NPs, PAs, and certified registered nurse anesthetists (CRNAs), and their collective feedback was used to finalize the survey prior to distribution. Descriptive statistics were used to describe and summarize the data. In addition, we assessed the association between respondents' characteristics and perceptions regarding NP and PA residency/fellowship programs using chi-squared tests of independence. Results The majority of the respondents (69.1%; 65/94) believed that starting an advanced practice residency/fellowship program at our AMC has many benefits such as increasing specialty-specific knowledge and training (79.8%; 75/94), improving medical decision-making (73.4%; 69/94), promoting professional development and clinical education (73.4%; 69/94), and improving procedural competency (60.6%; 57/94). Moreover, over half of the respondents (53.2%; 50/94) indicated that there is value in an APP residency/fellowship program obtaining optional accreditation. Additionally, over half of the respondents (56.4%; 53/94) indicated that they would be interested in participating as a clinical preceptor if an APP residency/fellowship program was developed at our AMC. Lastly, about one-third of the respondents felt strongly that APP residency/fellowship training programs should offer post-professional doctoral degree options such as Doctor of Nursing Practice (DNP), Doctor of Medical Science (DMSc), and Doctor of Health Science (DHSc). Conclusion Although most respondents have never completed a formalized postgraduate training program and were less familiar with the published literature regarding these programs, our findings suggest that the attitudes of employed NPs and PAs are generally positive toward the concept of postgraduate specialty-specific training.
引言
执业护士（NP）和医师助理（PA）的研究生住院医师/专科培训的正规培训呈指数级增长，且越来越受到关注。虽然这并非州执照和入门级实践的要求，但研究生NP和PA住院医师/专科培训项目为新毕业生以及希望转入新的医学或外科专科/亚专科的有经验的PA和NP提供了一条结构化途径。在本文中，我们研究了在职NP和PA对研究生培训的看法，包括在我们机构开展此类项目的想法。
方法
这是一项针对单一大型学术医疗中心（AMC）的横断面研究，最初由高级实践提供者（APP）主任制定了一份匿名电子调查问卷。该问卷由高级实践委员会（APC）的成员进行试点，该委员会成员包括NP、PA和注册护士麻醉师（CRNA），他们的集体反馈被用于在问卷分发前对其进行最终确定。描述性统计用于描述和总结数据。此外，我们使用独立性卡方检验评估了受访者的特征与对NP和PA住院医师/专科培训项目的看法之间的关联。
结果
大多数受访者（69.1%；65/94）认为在我们的AMC启动高级实践住院医师/专科培训项目有诸多益处，比如增加特定专科知识和培训（79.8%；75/94）、改善医疗决策（73.4%；69/94）、促进专业发展和临床教育（73.4%；69/94）以及提高操作能力（60.6%；57/94）。此外，超过一半的受访者（53.2%；50/94）表示APP住院医师/专科培训项目获得可选认证是有价值的。另外，超过一半的受访者（56.4%；53/94）表示如果我们的AMC开展APP住院医师/专科培训项目，他们有兴趣作为临床带教老师参与其中。最后，约三分之一的受访者强烈认为APP住院医师/专科培训项目应提供专业后博士学位选项，如护理实践博士（DNP）、医学科学博士（DMSc）和健康科学博士（DHSc）。
结论
虽然大多数受访者从未完成过正规的研究生培训项目，且对有关这些项目的已发表文献了解较少，但我们的研究结果表明，在职NP和PA对研究生特定专科培训概念的态度总体上是积极的。
